TGF-β1 And MCP-1 In Henoch-Schonlein Purpura Nephritis And IgA Nephritis

Background:Henoch-Schonlein purpura nephritis(HSPN) and IgA nephropathy(IgAN) are Pathologically similar,both of which feature obvious IgA diffuse deposition in glomerular,mesagial proiferation and crescent formation and clinically lead to hematuria,proteinuria and nephritis syndrome.Dispite of these similarities,the prognosis of two diseases can be totally different.As an acute pathological process, HSPN patients ended with good prognosis except some rareⅢtype patients,while most of chronic IgAN patients ended with end-stage renal failure.Questions are asked for the explanation of the different prognosis.Presently,some experts believe that the negtive factor causing poor prognosis of IgAN is progressive renal fibrosis and blocking even reversing the fibrosis may improve the prognosis of IgAN.Cytokines are consided to be important in the complicated process of renal fibrosis,of which Transforming growth factor-β1(TGF-β1) and Monocyte Chemo-attractant Protein-1(MCP-1) get extensive attention as key roles in the formation of renal fibrosis.Objective:observation of the degree of renal fibrosis in HSPN and IgAN patients. Evaluation of the expression of TGF-β1 and MCP-1 in these two diseases and the relation between renal fibrosis and these cytokines.Discussion of the role of TGF-β1 and MCP-1 in the process of renal fibrosis in IgAN.Method:50 HSPN and 50 IgAN patients were included by way of renal biopsy and 10 hematuria patients with mild lesion in glomerular and no immune complex deposition were included as control group.All of the samples were conducted with hematoxylin eosin(HE) dyeing,MASSON dyeing,electron microscopy and immunofluorescence examination and classified to different degree of renal fibrosis by Bohle A method.The expression level of MCP-1 and TGF-β1 were checked by immunohistochemistry.Results:The degree of renal fibrosis is much more serious in IgAN than in HSPN(P＜0.001 ) and no renal fibrosis was found in control group.The expression level of MCP-1 and TGF-β1 is much higher in IgAN than in HSPN(P＜0.001,P＜0.001 ).As the developememt of nephritic fibrosis,the expression level of MCP-1 and TGF-β1 rose higher and higher,which suggusted fibrosis is closly related to the expression of MCP-1 and TGF-β1(P＜0.001,P＜0.001).Conclutions:Nephritic fibrosis exsists in both IgAN and HSPN,but the degree of fibrosis is more serious in IgAN than in HSPN.The expression of MCP-1 and TGF-β1 is related to the degree of nephritic fibrosis and may participate the occurance and development of IgAN.